Concept of Health -WHO Definition, Various Dimensions, Determinants, and Health Indicators.

World Health Organisation (WHO) defines health as

“Health is a state of complete physical health, mental health, and social well-being and not merely the absence of disease or infirmity”.

Concept of Various Dimensions of the Health

Health encompasses various dimensions. Dimensions are interlinked. These all are vital for a holistic sense of well-being.

• 1. Physical health: It includes factors like fitness, nutrition, and absence of disease. It encompasses the overall active functioning of the human body.

• 2. Mental health: Sound mental health includes emotional stability, resilience, and the overall ability of an individual to cope with stress and life’s changes. Mental health is crucial for a sense of well-being.

• 3. Social health: Social health reflects an individual’s ability to maintain healthy relationships, connect with others, and engage in a supportive social environment.

• 4. Emotional health: Emotional health reflects understanding, managing, and expressing emotions in a healthy and constructive manner.

• 5. Environmental health: Several environmental factors like an atmosphere free from pollutants, availability of clean and hygienic water, and safe living conditions play vital roles in maintaining an individual’s overall health conditions.

• 6. Intellectual health: Various cognitive abilities, continuous learning, the capacity to think critically, and solving day-to-day problems are the intellectual health of an individual.

• 7. Occupational health: A person’s satisfaction and well-being in the workplace are occupational health. It includes factors like job security, work-life balance, and attitudes of seniors, juniors, and colleagues.

• 8. Spiritual health: Individual’s sense of purpose, values, and beliefs are under spiritual health. Spiritual health contributes to inner peace, fulfillment, and sound satisfaction.

• 9. Cultural health: Cultural health influences an individual’s health and well-being. Tradition, beliefs, and practices are cultural factors that affect an individual’s health.

• 10. Economic health: Financial stability and access to resources are the basic needs of individuals. They play a crucial role in the overall health of the individual.

Concept of Determinants of Health

Determinants of health are factors that influence an individual’s or a population's health. The World Health Organization (WHO) identifies the following three determinants of health that affect an individual and a population (community). These are (1) the social and economic environment, (2) the physical environment, and (3) the person’s individual characteristics and behaviors. It is inappropriate to blame individuals for poor health. The above-said factors and many other factors decide whether an individual and a population is healthy or not.

• 1. Income and social status: It includes income, employment, and social support. These are socioeconomic status. Higher socioeconomic status is linked to a better health.

• 2. Social support networks: Greater support from families, friends, and communities improves the health condition. Culture, customs, and traditions of families, friends, and communities affect the health condition.

• 3. Education: Low education is linked with low confidence, high stress, and poor health.

• 4. Health environment: A good diet, physical activity, no tobacco use, and no alcohol consumption develop good health.

• 5. Physical environment: It includes access to clean water, safe housing, a healthy workplace; a pollution-free environment, good roads, etc contribute to good health.

• 6. Genetics: Genetics decide life span and healthiness. Some diseases are genetically controlled such as diabetes. Balance diet, physically active life, smoking, alcohol consumption, ability to handle stress, and all challenges affect hereditary diseases.

• 7. Health services: Government policies and services have a significant impact on health. Access and use of government services prevent and treat disease.

• 8. Gender and age: Men and women suffer from different diseases. Similarly, the age of the patient also decides the disease conditions. Such as prostate problem occurs in male not in female. A prostate problem in a male increases with the increase of age.

• 9. Social determinants: These include factors like discrimination, social cohesion, and the availability of social services. These factors affect the health outcome of an individual and a population.

• Concept of health indicators

Health indicators are qualitative and quantitative measures that provide information about the overall health and well-being of individuals, communities, or populations.

Uses of health indicators: They help healthcare professionals, policymakers, and researchers to assess the health status of populations, track health trends over time, identify areas of improvement, to evaluate the effectiveness of health interventions and policies.

The following are some key health indicators.

• 1. Life Expectancy: The average number of years an individual survives.

• 2. Health-adjusted life expectancy (HALE): The number of years a person expects to live in good health conditions.

• 3. Mortality Rate: The number of deaths per 1.000 or 100,000 people in a year.

• 4. Infant Mortality Rate: The number of infant deaths before their first birthday per 1.000 births.

• 5. Child Mortality Rate: The number of child deaths under five years per 1,000 births in a given year.

• 6. Maternal Mortality Rate: The number of maternal deaths related to pregnancy and childbirth per 100,000 live births.

• 7. Disease incidences: Number of new cases of a specific disease over a specified time period. Such as diabetes, cancer, HIV, etc.

• 8. Disease prevalence: The percentage of the population suffering from a specific disease at a given point in time like diabetes, cancer, HIV, etc.

• 9. Smoking and alcohol consumption rate: These are crucial indicators to assess the prevalence of risk factors for various diseases.

• 10. Vaccination Coverage: Percentage of the population covered under the immunization schedule of the government.

• 11. Access to healthcare: Availability and accessibility to healthcare facilities and healthcare workers to the population.

• 12. Healthcare expenditure: Total amount of money spent by the country or individual. Often it is measured as a percentage of GDP.

• 13. Nutritional status: It includes obesity rates, micronutrient deficiencies, and malnutrition.

• 14. Physical activity level: The proportion of individuals who engage in regular physical activities, exercises, outdoor and indoor games require physical movements, etc.

• 15. Environmental health: Measures of air quality, water quality exposure to environmental; toxins, and their impact on health.

• 16. Mental health indicators: Measures mental health such as anxiety, depression, and suicide rates.

• 17. Healthcare quality indicator: Measures the healthcare quality such as patient satisfaction, hospital-acquired infection, medical errors, etc.

• 18. Health behavior indicators: Data on diet, exercise, and other habits that influence health.

• 19. Health literacy: The ability of the individual to understand and use health information.

• 20. Health inequalities: Disparities in healthcare outcomes and access to healthcare among different socioeconomic, racial or geographic groups.

Alok Bains